The COLOR II randomized trial addressed an important question in rectal cancer: can laparoscopic resection achieve the same cancer control as open surgery when total mesorectal excision is required? Patients with rectal cancer were randomized to laparoscopic or open surgery, with outcomes assessed for local recurrence, disease-free survival and overall survival. The long-term findings were reassuring. Local recurrence was similar between groups, while disease-free and overall survival were also comparable. The study therefore provided strong randomized evidence that minimally invasive rectal cancer surgery can achieve acceptable oncological outcomes when performed by experienced teams. The trial is particularly relevant because rectal surgery demands careful pelvic dissection and preservation of oncological planes, making concerns about incomplete resection especially important. For current practice, COLOR II supports a principle that remains central to rectal cancer surgery: the access route should not compromise the quality of total mesorectal excision. Patient selection, imaging-based staging, neoadjuvant treatment, surgical expertise and multidisciplinary decision-making remain essential. When those elements are in place, laparoscopic rectal resection can provide the benefits of minimally invasive surgery without an obvious trade-off in major long-term cancer outcomes.